Nutrition, Metabolism, and Diabetes

What Makes Kids Obese?

There are many contributing factors to the epidemic of childhood obesity. "Time" magazine did a special health issue titled Our Super-Sized Kids June 23, 2008 in which they tackle this very problem with a variety of different articles. Bryan Walsh writes an article looking at various factors that contribute to this problem ranging from income, ethnicity, and geography. He discovered some very interesting statistics from the CDC. He reports that obesity discriminates in a multitude of ways. Obesity discriminates by race, a 2006 study shows that 30.7 percent of white American kids are overweight or obese, compared with 34.9 percent of blacks and 38 percent of Mexican Americans.

Obesity discriminates by income, 22.4 percent of 10 to 17 year olds living below the poverty line, which is less than $21,000 for a family of four, are overweight or obese. As compared with 9.1 percent of kids whose families earn four times that amount. Walsh reports that obesity even discriminates by geography. A report by the National Survey of Children's Health done in 2003 showed that 16.5 percent of rural kids qualified as being obese, compared with 14.4 percent of urban kids. Walsh writes that the poorest states of the South and Appalachia which consist of Arkansas, West Virginia, Mississippi, and Kentucky have the heaviest children. Adult obesity levels triple when you cross north of 96 ^th street in Manhattan, leaving the mostly white and well off Upper East Side for the predominantly minority, poorer neighborhood of Spanish Harlem. ¹¹ Geography and income play an interesting role in this epidemic.

Walsh reports that it is the lack of good food choices that appears to play the greatest role in making poor kids fat. He says that it's not just that parents don't have enough time to cook and shop. Many times, the healthiest foods such as fruits and vegetables and whole grains, just are not available. Walsh says that many obese children live in what are called nutritional deserts, an area where there are few supermarkets nearby that offer the produce nutritionists are recommending. So families may have to rely on corner delis and bodegas, which tend to stock fattening, processed foods. ¹² Why? The HFCS, which may be in many of these foods, allows it to sit on the shelves indefinitely and also because it is cheaper. Supermarkets, where better choices are found, are three times as common in neighborhoods that are in the highest quintile (one fifth) of income as they are in neighborhoods in the lowest quintile of income. ¹³ A recent study found that the obesity rate among fifth, seventh, and ninth graders in the 10 poorest communities in Los Angeles County was 32 percent, compared to 8 percent for the city's wealthiest communities. ¹⁴ With the poorer communities not having the healthier food choices readily available, it makes sense that a single parent coming home from working two or three jobs is not in a position to offer their child the healthiest meal. If they have to travel long distances to provide a "healthy" meal for their child or children, it probably won't happen. In addition, healthier food tends to cost more. Single parents who are trying to make ends meet and stretch their money as far as they can will more than likely opt for the cheaper processed foods. This applies to families that may have two working parents.

Parents are always looking for ways to cut costs and they unknowingly may be making poor food choices. I look at the neighborhood my school is located in. Within half a block of the school are three "convenience" stores. None of them sell any fresh fruits or vegetables. The students at my school visit these stores quite frequently. One dollar can easily buy them one 20 ounce soda and two bags of potato chips. I see this combination or other variations of it so often during lunch because many times that's what the kids will claim to be their lunch. Up until about a year ago, our school was in a nutritional desert. Luckily a small grocery store chain opened a store and is now providing the fresh fruits and vegetables that were so desperately needed in the community. This is so important because many health experts are reporting that due to the obesity problems in children, this current generation may be the first in American history to have a shorter life expectancy than their parents. Neuroscientist Randy Seely, the associate director of the Obesity Research Center at the University of Cincinnati Medical School says, "When you're talking about morbidly obese kids, zero percent will grow up to be normal weight adults." ¹⁵ This is very scary. Dr. Seely has made a profound statement and should be a wake up call for parents and teachers alike.

Jeffrey Kluger in his article in Time titled "How America's Children Packed On the Pounds", writes about the potential futures of obese children. Obese boys and girls are already starting to develop the illnesses of excess associated with people in their 40's and beyond. Children are exhibiting symptoms of heart disease, liver disease, diabetes, gallstones, joint breakdown and even brain damage as fluid accumulation inside the skull leads to headaches, vision problems and possibly lower IQs. A staggering 90 percent of overweight kids already have at least one avoidable risk factor for heart disease, such as high cholesterol or hypertension. Type 2 diabetes is now being diagnosed in teens as young as 15. ¹⁶ An intervention has to be done to reverse this trend. Studies are now showing that the epidemic has begun to level off as parents become more aware and educated about what they can do to help themselves and their children.

Michael Pollan in his book In Defense of Food: An Eaters Manifesto writes about a study that was done in Australia in 1982 involving 10 Aborigines who were living in settlements in the town of Derby in Western Australia. These ten men had been living out of the bush for many years and adopted a lifestyle more consistent with modern America and Australia. They were very sedentary and no longer ate the native foods that they had grown up on but ate a more western diet which consisted mostly of processed and refined foods. All ten men had developed type 2 diabetes and a host of other illnesses. The 10 Aborigine men agreed to return to their traditional homeland where they would have no access to store food and beverages. They were to live off of the land for seven weeks, like their ancestors before them. Luckily for the men they had not forgotten the skills they learned earlier in their lives. They were accompanied by Kerin O'Dea a nutrition researcher who had designed the experiment.

When the men returned to their homeland, their diet consisted of mainly seafood but was supplemented by birds, kangaroo, witchetty grubs, freshwater fish, shellfish, turtle, crocodile, yams, figs, and bush honey. This diet was very different from what they ate in the settlements which consisted of flour, sugar, rice, carbonated drinks, alcoholic beverages, powdered milk, cheap fatty meat, potatoes, onions and other fruits and vegetables. After seven weeks in the bush, O'Dea tested the blood of the ten Aborigine men and found striking improvements in virtually every measure of their health. All had lost weight (an average of 17.9 pounds) and seen their blood pressure drop. Their triglyceride levels had fallen into the normal range. The proportion of omega-3 fatty acids in their tissues had increased dramatically. ¹⁷ To sum it all up, all the symptoms and elements of their type 2 diabetes had significantly decreased or disappeared altogether. Why bother to tell this story? In seven weeks, less than two months, the ten Aborigine men had reversed the effects of type 2 diabetes and had become overall, healthier men. That is remarkable! Seven weeks is not a long time, and if those men could do it in seven weeks, imagine what could be accomplished with our kids in one school year! A child's body is much more resilient than an adult's body. If we educate the parents as well as the kids, significant changes can be made in the lives of our children. We are going to take it step by step starting with reducing the consumption of HFCS and move up the scale until the kids and parents are better informed about how to make good healthy food choices.

Joseph Thompson, the director of the Arkansas Center for Health Improvement sums it up the best. "This (obesity) is not a disease that will be solved with medicines or vaccines. A social movement has to solve this." ¹⁸ Well said Dr. Thompson. I would like to take on the challenge issued by Dr. Thompson and start the social movement in my classroom. With education, determination, and a little luck, the movement will spread to the home, other classes, the school, and hopefully the district. From there the sky is the limit!

My goal and objectives for this unit are to teach my students about the dangers of HFCS and to take steps to limit their consumption. One easy way to do this is to look at the soft drinks that they drink and try to steer them and their parents to other healthier alternatives. We will keep a food journal for a week and look at the different foods that we have eaten. I am also going to keep a food journal with them so that I can monitor the food that I am eating also. We are going to look at websites like http://www.calorie-count.com/ which has an extensive list of foods and displays their nutritional content very similarly to what my students will see on any package of food they buy. It also has very easy to read graphical displays of the nutritional content as well as grades from A to F on how healthy a food is for eating. We will also look at the website http://www.calorieking.com/ which also has an extensive database of foods but has a unique feature which is it will display different exercises and the amount of time a person would have to do those exercises to burn off the calories they just consumed. The average person needs about 2,000 calories a day. For children it can be a little more or a little less depending on how active or sedentary they are. Using these various calorie counting websites we are going to see how many calories we are consuming in a day.

One of the books I am going to be using is Food is Elementary: A Hands-on Curriculum for Young Students by Antonia Demas, PhD. Dr. Demas has written a wonderful curriculum for all ages that has hands-on lessons and recipes that kids from all grade levels can use at school and at home. Dr. Demas is passionate about educating children about food. She writes a moving introduction which I would like to share excerpts from.

If children consume healthy plant-based foods in the school lunch program, billions of dollars in health care costs can be avoided in the United States in years to come. The relationship between diet and chronic disease must also be addressed through education. Most children do not learn about the relationship of diet and chronic disease at home. As a result, schools must take a leadership role in educating children about the relationship between diet and disease in order to make food choices with promote health rather than disease. We owe it to our children to serve them meals that will benefit their health and well-being. This is especially true for poor children who depend on school meals for a significant amount of their daily calories. Antonia Demas, PhD Food is Elementary, 2001

Teachers today have to take on a myriad of other roles in the classroom besides "teacher." There have been times when I have had to be a mom, dad, nurse, referee, custodian, judge, jury, counselor, and cheerleader. With so many other things demanding our time, this may seem like one more hand pulling on our coattails. But if we really care about our kids than Dr. Demas has hit the nail on the head. Schools have to take a leading role in not only educating our kids about how to eat properly, but also their parents.

Here are some ways that my students are going to learn about how we can avoid the pitfalls of HFCS and other added sugars. I am going to have different kinds of soft drinks on display and we are going to figure out which ones are the best for you. They will know by the end of that lesson to buy only 100 percent juice instead of fruit "drinks," "punches," cocktails," or "-ades" which are really code words for added sugar, usually HFCS. ¹⁹ Students should limit their juice to one 8-ounce serving a day. If the student has a choice, they should choose whole fruits over fruit juices. Even 100 percent juices have a concentrated source of fructose and calories without the fiber and nutrients found in whole fruits. My students will also learn to cut back on soda. We are going to do a lesson where we will use linking cubes where each cube will represent one teaspoon of sugar. There will be various food items and we will link cubes to represent how many tablespoons of sugar there are in each item. When they observe that a typical can of soda has anywhere between ten and thirteen teaspoons of sugar, they will hopefully see that in one can of soda they are getting all of the sugar that the United States Department of Agriculture says they should have in a day. I believe that this will be an eye opening experience. We will then talk about what are better choices for them to drink such as water (the best choice), seltzer, sugar-free iced tea and low-fat milk instead of soda.

Another lesson will be looking at canned fruits. Which canned fruit is the better choice: the fruit in juice or the fruit in heavy syrup? We will then talk about which one is better and why and talk about other options if they have to choose a processed fruit like choosing unsweetened applesauce and even frozen fruits.

Another lesson will look at the choices of nuts, cheese, and candy for a possible snack. It will be understood that if fruit is an option that should always be the first choice. However, out of the three, my students will discover that a handful of nuts or even a chunk of cheese (not the pre-sliced American) is much better for the body than candy. We will also look at what to eat for breakfast, the most important meal of the day. This can be a challenge because New Haven provides free breakfast for all elementary/middle schools. The breakfasts usually consist of some generic version of a name brand sweet cereal. Sometimes it will be a muffin or graham crackers. Each breakfast comes with fruit juice and milk. We will analyze the cereal that we are given everyday and determine its nutritional value. We design a more healthful breakfast which should consist of oatmeal or a bowl of low-sugar whole-grain cereal, fruit, and low fat milk. This breakfast is infinitely better than cereal bars, toaster pastries, doughnuts, sweet rolls, or danishes.